Diagnosis and Management of Acanthamoeba Keratitis: A Continental Approach

Abstract

Acanthamoeba keratitis (AK) is a potentially blinding infection caused by protozoa found worldwide. The topical application of biguanides and diamidines is the most common anti-amoebic treatment for AK. In this study, we hypothesized that geographical location and socioeconomic status influence the management and treatment of AK. To test this hypothesis, we analyzed case reports and series of Acanthamoeba eye infections from different geographic regions to evaluate the association between diagnosis, treatment, and outcome worldwide. This study looked specifically at case reports of patients with diagnosed AK using bibliographic databases such as PubMed, BioMed Central, and Google Scholar, which were searched between 30 April 1990 and 1 May 2022. The search identified 38 eligible studies that provided data for 60 clinical cases of AK. The results indicated that current standard treatments are effective if the infection is identified early and that delays can lead to clinical symptoms, including permanent visual opacities. There was evidence suggesting an association between the treatment regimen practiced in certain geographic regions and treatment outcome. Patient access to medical facilities and economic background also had an influence on the treatment and outcome of AK. Further analysis of more case reports can expand our understanding of the influence of specific demographic and individual patient characteristics on the effectiveness and accessibility of AK medicines. Additionally, using a living systematic review approach to incorporate emerging evidence will reveal the relative merits of different treatment regimens for AK and outcomes.